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| 1 | Cetuximab plus FOLFOX6 or FOLFIRI in metastatic colorectal cancer: CECOG trial显示文摘AIM: To investigate efficacy and safety of cetuximab combined with two chemotherapy regimens in patients with unresectable metastatic colorectal cancer (mCRC). METHODS: Randomized patients received cetuximab with 5-fluorouracil (5-FU), folinic acid (FA) and oxaliplatin (FOLFOX) 6 (arm A, n = 74) or 5-FU, FA and irinotecan (FOLFIRI) (arm B, n = 77). KRAS mutation status was determined retrospectively in a subset of tumors (n = 117). RESULTS: No significant difference was found between treatment arms A and B in the progression-free survival (PFS) rate at 9 mo, 45% vs 34%; median PFS, 8.6 mo vs 8.3 mo [hazard ratio (HR) = 1.06]; overall response rate (ORR) 43% vs 45% [odds ratio (OR) = 0.93] and median overall survival (OS), 17.4 mo vs 18.9 mo (HR = 0.98). Patients with KRAS wild-type tumors demonstrated improved PFS (HR = 0.55, P = 0.0051), OS, (HR = 0.62, P = 0.0296) and ORR (53% vs 36%) and in arm A, improved PFS (HR = 0.49, P = 0.0196), OS (HR = 0.48, P = 0.0201) and ORR (56%vs 30%), compared with patients with KRAS mutated tumors. In arm B no significant differences were found in efficacy by KRAS mutation status. Treatment in arms A and B was generally well tolerated. CONCLUSION: This study confirms that combinations of cetuximab with FOLFOX6 or FOLFIRI are effective and significantly improve clinical outcome in KRAS wild-type compared with KRAS mutated mCRC. | Janja Ocvirk Thomas Brodowicz Fritz Wrba Tudor E Ciuleanu Galina Kurteva Semir Beslija Ivan Koza Zsuzsanna Pápai Diethelm Messinger Ugur Yilmaz Zsolt Faluhelyi Suayib Yalcin Demetris Papamichael Miklós Wenczl Zrinka Mrsic-Krmpotic Einat Shacham-Shmueli Damir Vrbanec Regina Esser Werner Scheithauer Christoph C Zie-linski | 2010 | World Journal of Gastroenterology2010，16，25： | 17 |
| 2 | Management of postoperative spinal infections显示文摘Postoperative surgical site infection(SSI) is a common complication after posterior lumbar spine surgery. This review details an approach to the prevention,diagnosis and treatment of SSIs. Factors contributing to the development of a SSI can be split into three categories:(1) microbiological factors;(2) factors related to the patient and their spinal pathology; and(3) factors relating to the surgical procedure. SSI is most commonly caused by Staphylococcus aureus. The virulence of the organism causing the SSI can affect its presentation. SSI can be prevented by careful adherence to aseptic technique,prophylactic antibiotics,avoiding myonecrosis by frequently releasing retractors and preoperatively optimizing modifiable patient factors. Increasing pain is commonly the only symptom of a SSI and can lead to a delay in diagnosis. C-reactive protein and magnetic resonance imaging can help establish the diagnosis. Treatment requires acquiring intra-operative cultures to guide future antibiotic therapy and surgical debridement of all necrotic tissue. A SSI can usually be adequately treated without removing spinalinstrumentation. A multidisciplinary approach to SSIs is important. It is useful to involve an infectious disease specialist and use minimum serial bactericidal titers to enhance the effectiveness of antibiotic therapy. A plastic surgeon should also be involved in those cases of severe infection that require repeat debridement and delayed closure. | Vishal Hegde Dennis S Meredith Christopher K Kepler Russel C Huang | 2012 | World Journal of Orthopedics2012，3，11： | 17 |
| 3 | Acute abdominal obstruction:Colon stent or emergency surgery? An evidence-based review显示文摘According to the American Cancer Society and Colorectal Cancer Statistics 2017,colorectal cancer(CRC) is one of the most common malignancies in the United States and the second leading cause of cancer death in the world in 2018.Previous studies demonstrated that 8%-29% of patients with primary CRC present malignant colonic obstruction(MCO). In the past, emergency surgery has been the primary treatment for MCO, although morbidity and surgical mortality rates are higher in these settings than in elective procedures. In the 1990 s, selfexpanding metal stents appeared and was a watershed in the treatment of patients in gastrointestinal surgical emergencies. The studies led to high expectations because the use of stents could prevent surgical intervention, such as colostomy, leading to lower morbidity and mortality, possibly resulting in higher quality of life. This review was designed to provide present evidence of the indication, technique, outcomes, benefits, and risks of these treatments in acute MCO through the analysis of previously published studies and current guidelines. | Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura Christopher C Thompson Eduardo Guimaraes Hourneaux de Moura | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，3： | 15 |
| 4 | Encapsulating peritoneal sclerosis显示文摘Encapsulating peritoneal sclerosis(EPS) is a debilitating condition characterized by a fibrocollagenous membrane encasing the small intestine, resulting in recurrent small bowel obstructions. EPS is most commonly associated with long-term peritoneal dialysis, though medications, peritoneal infection, and systemic inflammatory disorders have been implicated. Many cases remain idiopathic. Diagnosis is often delayed given the rarity of the disorder combined with non-specific symptoms and laboratory findings. Although cross-sectional imaging with computed tomography of the abdomen can be suggestive of the disorder, many patients undergo exploratory laparotomy for diagnosis. Mortality approaches 50% one year after diagnosis. Treatment for EPS involves treating the underlying condition or eliminating possible inciting agents(i.e. peritoneal dialysis, medications, infections) and nutritional support, frequently with total parenteral nutrition. EPSspecific treatment depends on the disease stage. In the inflammatory stage, corticosteroids are the treatment of choice, while in the fibrotic stage, tamoxifen may be beneficial. In practice, distinguishing between stages may be difficult and both may be used. Surgical intervention, consisting of peritonectomy and enterolysis, is timeconsuming and high-risk and is reserved for situations in which conservative medical therapy fails in institutions with surgical expertise in this area. Herein we review the available literature of the etiology, pathogenesis, diagnosis, and treatment of this rare, but potentially devastating disease. | Christopher J Danford Steven C Lin Martin P Smith Jacqueline L Wolf | 2018 | World Journal of Gastroenterology2018，24，28： | 13 |
| 5 | Impact of concomitant use of proton pump inhibitors and clopidogrel or ticagrelor on clinical outcomes in patients with acute coronary syndrome显示文摘BackgroundThere 是在质子泵禁止者(PPI ) 和 clopidogrel 之间的可能的不利相互作用上的大争论。另外, PPI 的使用是否少些影响 ticagrelor 遗体的临床的功效,知道。在经皮的冠的干预(一种总线标准) .MethodsWe 回顾地从 “ 分析了数据以后,我们试图与急性冠的症候群(交流)在病人在临床的结果上决定 PPI 和 clopidogrel 或 ticagrelor 的伴随物管理的影响;真实 world” ;,国际,在 2003 和 2014 之间的多中心登记( n = 15,401 )并且在1年的合成主要端点上估计了 PPI 和 clopidogrel 或 ticagrelor 的伴随物管理的影响(所有原因死亡收到 PPI 的病人更老,更经常女性,并且是更可能的有 comorbidities。没有协会为收到 clopidogrel 的病人在 PPI 使用和主要端点之间被观察(调整 HR:1.036;95% CI:0.903-1.189 ) 或 ticagrelor (调整 HR:2.320;95% CI:0.875-6.151 )(P 相互作用 = 0.2004 ) 。同样, PPI 的使用没与所有原因死亡,重新梗塞,或与交流后面的一种总线标准的为与任何一个 clopidogrel 对待的病人或 ticagrelor.ConclusionsIn 病人的严重流血的减少的风险的增加的风险被联系, PPI 的伴随物使用没在收到 clopidogrel 或 ticagrelor 的病人与不利结果的增加的风险被联系。我们的调查结果显示与 clopidogrel 或 ticagrelor 在联合使用 PPI 是合理的,特别在有胃肠的流血的更高的风险的病人。 | Yan YAN Xiao WANG Jing-Yao FAN Shao-Ping NIE Sergio Raposeiras-Roubin Emad Abu-Assi Jose P Simao Henriques Fabrizio D'Ascenzo Jorge Saucedo Jose R Gonzfilez-Juanatey Stephen B Wilton Wouter J Kikkert Ivlin Nufiez-Gil Albert Ariza-Sole Xian-Tao SONG Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis C Correia Masa-aki Kawashiril Sasko Kedev | 2016 | Journal of Geriatric Cardiology2016，13，3： | 12 |
| 6 | Comparison of sperm retrieval and reproductive outcome in azoospermic men with testicular failure and obstructive azoospermia treated for infertility显示文摘我们估计了精子检索和 intracytoplasmic 精子注射结果的率,包括构思的婴儿的新生的侧面,在有阴囊的失败的人。三 -- 经历了微解剖的阴囊的精子抽取的有阴囊的失败的 165 个人在这研究被包括。我们把他们的结果与 40 作比较为注射使用了施主精子由于的有阴囊的失败的人与妨碍的精子缺乏没有通过检索,和 146 个人经历了经皮的精子检索。在阴囊的失败的检索率是 41.4% ,并且结果比妨碍的精子缺乏低(100% ;调整机会比率:0.033;95% CI:0.007-0.164;P <0.001 ) 。在精子注射以后的实时出生率与施主精子相比在有阴囊的失败(19.9%) 的人是更低的(37.5% ;调整或:0.377 (95% CI:0.233-0.609, P <0.001 )) 并且妨碍的精子缺乏(34.2% ;调整或:0.403 (95% CI:0.241-0.676, P = 0.001 ) 。构思的婴儿的新生的参数不在这些组之中是显著地不同的。我们断定在检索上获得精子并且在 intracytoplasmic 精子注射(ICSI ) 以后完成实时出生的机会与阴囊的失败在人被减少。在精子注射不似乎被阴囊的失败否定地影响以后,婴儿的侧面怀孕了。 | Sandro C Esteves Christina Prudencio Bill Seol Sidney Verza jr Christopher Knoedler Ashok Agarwal | 2014 | Asian Journal of Andrology2014，16，4： | 9 |
| 7 | Vanishing bile duct syndrome in human immunodeficiency virus infected adults:A report of two cases显示文摘Vanishing bile duct syndrome(VBDS) is a group of rare disorders characterized by ductopenia,the progressive destruction and disappearance of intrahepatic bile ducts leading to cholestasis.Described in association with medications,autoimmune disorders,cancer,transplantation,and infections,the specific mechanisms of disease are not known.To date,only 4 cases of VBDS have been reported in human immunodeficiency virus(HIV) infected patients.We report 2 additional cases of HIV-associated VBDS and review the features common to the HIV-associated cases.Presentation includes hyperbilirubinemia,normal liver imaging,and negative viral and autoimmune hepatitis studies.In HIV-infected subjects,VBDS occurred at a range of CD4+ T-cell counts,in some cases following initiation or change in antiretroviral therapy.Lymphoma was associated with two cases;nevirapine,antibiotics,and viral co-infection were suggested as etiologies in the other cases.In HIV-positive patients with progressive cholestasis,early identification of VBDS and referral for transplantation may improve outcomes. | Ana Paula Oppenheimer Christopher Koh Mary McLaughlin John C Williamson Thomas D Norton Jennifer Laudadio Theo Heller David E Kleiner Kevin P High Caryn G Morse | 2013 | World Journal of Gastroenterology2013，19，1： | 8 |
| 8 | Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013显示文摘 | Marie Ng Tom Fleming Margaret Robinson Blake Thomson Nicholas Graetz Christopher Margono Erin C Mullany Stan Biryukov Cristiana Abbafati Semaw Ferede Abera Jerry P Abraham Niveen M E Abu-Rmeileh Tom Achoki Fadia S AlBuhairan Zewdie A Alemu Rafael Alfonso | 2014 | The Lancet2014，，： | 7 |
| 9 | Highly efficient derivation of ventricular cardiomyocytes from induced pluripotent stem cells with a distinct epigenetic signature显示文摘从 pluripotent 干细胞导出的 Cardiomyocytes 能在药测试,疾病建模和基于房间的治疗被使用。没有 procardiogenic 生长因素,然而,从 pluripotent 干细胞的 cardiomyogenesis 的效率通常是低的,产生 cardiomyocyte 人口是异构的。这里,我们证明导致的 pluripotent 干细胞( iPSCs )能从鼠科的室的 myocytes ( VM )被导出,并且与从各种各样的体的房间类型导出的 iPSCs 的另外的报告一致,自发地作为与遗传上匹配的胚胎的干细胞(转换字符)或 iPSCs 相比区分 cardiomyocytes 进跳动的显著地更高的倾向从尾巴尖端成纤维细胞导出的 导出VM 的 iPSCs ( ViPSCs )展览。惊人地,导出 ViPSC 的 cardiomyocytes 显示的多数室的显型。在 ViPSCs 的提高的室的 myogenesis 在区别的早阶段经由心血管的祖先的增加的数字被调停。以便从 ViPSCs 调查提高的室的 myogenesis 的机制,我们执行了全球基因表示和 DNA methylation 分析,它揭示了可以涉及在 pluripotent 干细胞指定 VM 命运的不同 epigenetic 签名。 | Huansheng Xu B Alexander Yi Hao Wu Christoph Bock Hongcang Gu Kathy O Lui Joo-Hye C Park Ying Shao Alyssa K Riley Ibrahim J Domian Erding Hu Robert Willette John Lepore Alexander Meissner Zhong Wang Kenneth R Chien | 2012 | Cell Research2012，22，1： | 7 |
| 10 | Small bowel MRI enteroclysis or follow through:Which is optimal?显示文摘AIM:To determine if a nasojejunal tube(NJT) is required for optimal examination of enteroclysis and if patients can be examined only in the supine position.METHODS:Data were collected from all patients undergoing small bowel(SB) magnetic resonance imaging(MRI) examination over a 32-mo period.Patients either underwent a magnetic resonance(MR) follow-through(MRFT) or a MR enteroclysis(MRE) in the supine position.The quality of proximal and distal SB distension as well as the presence of motion artefact and image quality were assessed by 2 radiologists.RESULTS:One hundred and fourteen MR studies were undertaken(MRFT-49,MRE-65) in 108 patients in the supine position only.Image artefact was more frequent in MRE than in MRFT(29.2% vs 18.4%) ,but was not statistically significant(P = 0.30) .Adequate distension of the distal SB was obtained in 97.8% of MRFT examinations and in 95.4% of MRE examinations,respectively.Proximal SB distension was,however,less frequently optimal in MRFT than in MRE(P = 0.0036) ,particularly in patients over the age of 50 years(P = 0.0099) .Image quality was good in all examinations.CONCLUSION:All patients could be successfully imaged in the supine position.MRE and MRFT are equivalent for distal SB distension and artefact effects.Proximal SB distension is frequently less optimal in MRFT than in MRE.MRE is,therefore,the preferred MR examination method of the SB. | Ian C Lawrance Christopher J Welman Peter Shipman Kevin Murray | 2009 | World Journal of Gastroenterology2009，15，42： | 7 |
| 11 | Role of endoscopic vacuum therapy in the management of gastrointestinal transmural defects显示文摘A gastrointestinal(GI) transmural defect is defined as total rupture of the GI wall,and these defects can be divided into three categories: perforations,leaks,and fistulas. Surgical management of these defects is usually challenging and may be associated with high morbidity and mortality rates. Recently,several novel endoscopic techniques have been developed,and endoscopy has become a firstline approach for therapy of these conditions. The use of endoscopic vacuum therapy(EVT) is increasing with favorable results. This technique involves endoscopic placement of a sponge connected to a nasogastric tube into the defect cavity or lumen. This promotes healing via five mechanisms,including macrodeformation,microdeformation,changes in perfusion,exudate control,and bacterial clearance,which is similar to the mechanisms in which skin wounds are treated with commonly employed wound vacuums. EVT can be used in the upper GI tract,small bowel,biliopancreatic regions,and lower GI tract,with variable success rates and a satisfactory safety profile. In this article,we review and discuss the mechanism of action,materials,techniques,efficacy,and safety of EVT in the management of patients with GI transmural defects. | Diogo Turiani Hourneaux de Moura Bruna Furia Buzetti Hourneaux de Moura Michael A Manfredi Kelly E Hathorn Ahmad N Bazarbashi Igor Braga Ribeiro Eduardo Guimaraes Hourneaux de Moura Christopher C Thompson | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，5： | 6 |
| 12 | P2Y12受体抑制剂联合质子泵抑制剂对急性冠脉综合征患者缺血事件影响的临床分析显示文摘目的本研究旨在分析P2Y12受体抑制剂联合质子泵抑制剂(PPI)治疗对经皮冠状动脉介入(PCI)术后的急性冠脉综合征患者缺血事件的影响。方法基于国际多中心回顾性注册登记研究,纳入2003至2014年因急性冠脉综合征人院行PCI术的患者,分为PPI组及非PPI组并随访1年,主要临床终点为全因死亡/再发心肌梗死的复合终点。根据P2Y12受体抑制剂种类,将入组患者分为氯吡格雷组及替格瑞洛组,并比较不同药物与PPI联用发生临床终点事件的风险。结果研究入选9429例患者,PPI组占54.8%,具有更多高危因素。Cox回归结果提示PPI组较非PPI组全因死亡/再发心肌梗死复合事件的发生差异无统计学意义(HR1.00,95%CI 0.86—1.18)。根据P2Y12抑制剂种类不同分为氯吡格雷组和替格瑞洛组,不同P2Y12受体抑制剂联用PPI较未联用PPI患者的临床终点无差异,联用PPI的氯吡格雷组与替格瑞洛组的临床终点差异也无统计学意义。结论急性冠脉综合征患者PPI与P2Y12受体抑制剂联用不增加全因死亡和再发心肌梗死风险,尤其PPI联用氯吡格雷在患者的缺血事件上与替格瑞洛比较差异无统计学意义。 | 冯斯婷 严妍 范婧尧 王晓 郑文 聂绍平 Sergio Raposeiras-Roubin Emad Abu-Assi Jose P Simao Henriques Fabrizio D' Ascenzo Jorge Saucedo Jose R Conzalez-Juanatey Stephen B Wilton Wouter J Kikkert Ivan Nunez-Gil Albert Ariza-Sole Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis C Correia Masa-aki Kawashiri Sasko Kedev | 2016 | 中华医学杂志2016，96，33： | 6 |
| 13 | Clinical outcomes following salvage Gamma Knife radiosurgery for recurrent glioblastoma显示文摘Glioblastoma multiforme(GBM) is the most common malignant primary brain tumor with a survival prognosis of 14-16 mo for the highest functioning patients. Despite aggressive, multimodal upfront therapies, the majority of GBMs will recur in approximately six months. Salvage therapy options for recurrent GBM(r GBM) are an area of intense research. This study compares recent survival and quality of life outcomes following Gamma Knife radiosurgery(GKRS) salvage therapy. Following a Pub Med search for studies usingGKRS as salvage therapy for malignant gliomas, nine articles from 2005 to July 2013 were identified which evaluated rG BM treatment. In this review, we compare overall survival following diagnosis, overall survival following salvage treatment, progression-free survival, time to recurrence, local tumor control, and adverse radiation effects. This report discusses results for rG BM patient populations alone, not for mixed populations with other tumor histology grades. All nine studies reported median overall survival rates(from diagnosis, range:16.7-33.2 mo; from salvage, range:9-17.9 mo). Three studies identified median progression-free survival(range:4.6-14.9 mo). Two showed median time to recurrence of GBM. Two discussed local tumor control. Six studies reported adverse radiation effects(range:0%-46% of patients). The greatest survival advantages were seen in patients who received GKRS salvage along with other treatments, like resection or bevacizumab, suggesting that appropriately tailored multimodal therapy should be considered with each rG BM patient. However, there needs to be a randomized clinical trial to test GKRS for rG BM before the possibility of selection bias can be dismissed. | Erik W Larson Halloran E Peterson Wayne T Lamoreaux Alexander R MacKay Robert K Fairbanks Jason A Call Jonathan D Carlson Benjamin C Ling John J Demakas Barton S Cooke Christopher M Lee | 2014 | World Journal of Clinical Oncology2014，5，2： | 5 |
| 14 | Natural orifice translumenal surgery:Flexible platform review显示文摘Natural orifice translumenal surgery(NOTES) has garnished significant attention from surgeons and gastroenterologists,due to the fusion of flexible endoscopy and operative technique.Preliminary efforts suggest that NOTES holds potential for a less invasive approach with certain surgical conditions.Many of the hurdles encountered during the shift from open to laparoscopic surgery are now being revisited in the development of NOTES.Physician directed efforts,coupled with industry support,have brought about several NOTES specific devices and platforms to help address limitations with current instrumentation.This review addresses current flexible platforms and their attributes,advantages,disadvantages and limitations. | Sohail N Shaikh Christopher C Thompson | 2010 | World Journal of Gastrointestinal Surgery2010，2，6： | 5 |
| 15 | Are acute exacerbations of chronic inflammatory appendicitis triggered by coprostasis and/or coproliths?显示文摘AIM: To examine the role of coprostasis and coproliths in recurrent appendicitis. METHODS: We evaluated four hundred and twenty seven consecutive pathology reports of all appende- ctomy specimens from January 2003 to December 2004. Findings were categorised as showing acute appen- dicitis, acute recurrent appendicitis, subacute recurrent appendicitis, chronic appendicitis, or appendices without inflammation. All patients had presented with acute right lower quadrant pain. In 94 instances, there was a history of recurrent similar episodes in the past. RESULTS: Of the 427 histology reports, 294 were inter- preted as showing acute appendicitis, 56 acute recurrent appendicitis, 34 subacute recurrent appen-dicitis, 28 chronic appendicitis, and 15 non-inflamed appendices. Coprostasis was observed in 58 patients (13.58%) and the presence of coprolith in 6 (1.4%). Coprostasis, and age, were among the predictors in the final model. CONCLUSION: Coprostasis but not coproliths seems to be a contributing factor to acute exacerbations of chronic inflammatory appendicitis. | George Sgourakis Georgios C Sotiropoulos Ernesto P Molmenti Charis Eibl Stylianous Bonticous Jurgen Moege Christoph Berchtold | 2008 | World Journal of Gastroenterology2008，14，20： | 5 |
| 16 | Bilateral vs unilateral placement of metal stents for inoperable highgrade hilar biliary strictures: A systemic review and meta-analysis显示文摘BACKGROUND Bilateral vs unilateral biliary stenting is used for palliation in malignant biliary obstruction.No clear data is available to compare the efficacy and safety of bilateral biliary stenting over unilateral stenting.AIM To assess the efficacy and safety of bilateral vs unilateral biliary drainage in inoperable malignant hilar obstruction.METHODS PubMed,Embase,Scopus,and Cochrane databases,as well as secondary sources(bibliographic review of selected articles and major GI proceedings),were searched through January 2019.The primary outcome was the re-intervention rate.Secondary outcomes were a technical success,early and late complications,and stent malfunction rate.Pooled odds ratio(OR)and 95%confidence interval(CI)were calculated for each outcome.RESULTS A total of 9 studies were included(2 prospective Randomized Controlled Study,5 retrospective studies,and 2 abstracts),involving 782 patients with malignant hilar obstruction.Bilateral stenting had significantly lower re-intervention rate compared with unilateral drainage(OR=0.59,95%CI:0.40-0.87,P=0.009).There was no difference in the technical success rate(OR=0.7,CI:0.42-1.17,P=0.17),early complication rate(OR=1.56,CI:0.31-7.75,P=0.59),late complication rate(OR=0.91,CI:0.58-1.41,P=0.56)and stent malfunction(OR=0.69,CI:0.42-1.12,P=0.14)between bilateral and unilateral stenting for malignant hilar biliary strictures.CONCLUSION Bilateral biliary drainage had a lower re-intervention rate as compared to unilateral drainage for high grade inoperable malignant biliary strictures,with no significant difference in technical success,and early or late complication rates. | Munish Ashat Sumant Arora Jagpal S Klair Christopher A Childs Arvind R Murali Frederick C Johlin | 2019 | World Journal of Gastroenterology2019，25，34： | 5 |
| 17 | Bcl-x_L and Myeloid cell leukaemia-1 contribute to apoptosis resistance of colorectal cancer cells显示文摘AIM: To explore the role of Bcl-xL and Myeloid cell leukaemia (Mcl)-1 for the apoptosis resistance of colorectal carcinoma (CRC) cells towards current treat-ment modalities. METHODS: Bcl-xL and Mcl-1 mRNA and protein ex-pression were analyzed in CRC cell lines as well as human CRC tissue by Western blot,quantitative PCRand immunohistochemistry. Bcl-xL and Mcl-1 protein expression was knocked down or increased in CRC cell lines by applying specific siRNAs or expression plas-mids,respectively. After modulation of protein expres-sion,CRC cells were treated with chemotherapeutic agents,an antagonistic epidermal growth factor recep-tor (EGFR1) antibody,an EGFR1 tyrosine kinase inhibi-tor,or with the death receptor ligand TRAIL. Apoptosis induction and cell viability were analyzed. RESULTS: Here we show that in human CRC tis-sue and various CRC cell lines both Bcl-xL and Mcl-1 are expressed. Bcl-xL expression was higher in CRC tissue than in surrounding non-malignant tissue,both on protein and mRNA level. Mcl-1 mRNA expression was significantly lower in ma-lignant tissues. However,protein expression was slightly higher. Viability rates of CRC cells were significantly decreased after knock down of Bcl-xL expression,and,to a lower extent,after knock down of Mcl-1 expression. Furthermore,cells with reduced Bcl-xL or Mcl-1 expression was more sensitive towards oxaliplatin-and irinotecan-induced apoptosis,and in the case of Bcl-xL also towards 5-FU-induced apoptosis. On the other hand,upregulation of Bcl-xL by transfec-tion of an expression plasmid decreased chemothera-peutic drug-induced apoptosis. EGF treatment clearly induced Bcl-xL and Mcl-1 expression in CRC cells. Apop-tosis induction upon EGFR1 blockage by cetuximab or PD168393 was increased by inhibiting Mcl-1 and Bcl-xL expression. More strikingly,CD95-and TRAIL-induced apoptosis was increased by Bcl-xL knock down. CONCLUSION: Our data suggest that Bcl-xL and,to a lower extent,Mcl-1,are important anti-apoptotic factors in CRC. Specific downregulation of Bcl-xL is a promising approach to sensitize CRC cells towards chemotherapy and targeted therapy. | Henning Schulze-Bergkamen Roland Ehrenberg Lothar Hickmann Binje Vick Toni Urbanik Christoph C Schimanski Martin R Berger Arno Schad Achim Weber Steffen Heeger Peter R Galle Markus Moehler | 2008 | World Journal of Gastroenterology2008，14，24： | 4 |
| 18 | Improved hemostasis with major hepatic resection in the current surgical era显示文摘Background: Major hepatic resection, predominantly performed for oncologic intent, is a complex procedure with the potential for severe intraoperative hemorrhage. The current surgical era has the ability to improve hemostasis throughout the performance of major hepatic resections which decreases blood transfusions and the detrimental effects associated with transfusion. We evaluated hemostasis and outcomes in the current surgical era of performing hepatic resections. Methods: Utilizing the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database all major hepatic resections performed between 2012 and 2016 were analyzed in regards to hemostasis. Hemostasis was evaluated by the need for and magnitude of blood transfusions. Additional perioperative variables (including operative time, length of hospital stay, and mortality rates) were analyzed to assess for outcomes with hemostasis. The NSQIP results were compared to previous publications involving major hepatic resections to detect improvement in hemostasis and outcomes in the current surgical era. Results: A total of 22777 major hepatic resections met the inclusion criteria for analysis in the NSQIP database. An additional 21198 cases were compiled within the selected publications for comparative analysis. The transfusion rate in the current surgical era was 13.3% versus 38.7% in the previous era ( P = 0.0001). When a transfusion was required in the current surgical era there was a two-fold reduction in the number of units transfused (1.5 U vs. 3.8 U, P = 0.0001). Statistically significant improvements in operative time and length of hospital stay were presented within the current surgical era ( P = 0.0001). When a transfusion was required there was an increased relative risk score of 7 for mortality (4.9% vs. 0.7%, P = 0.0001), however, improvement in mortality rates did not reach statistical significance across surgical eras (1.3% vs. 4.0%, P = 0.0001). Conclusions: The conduction of major hepatic resection in the current surgical era is more hemostatic. Correlated with improved hemostasis are better outcomes for both clinical and financial endpoints. These findings should encourage continued and increased performance of major hepatic resections. | Christopher W Mangieri Matthew A Strode Bradley C Bandera | 2019 | Hepatobiliary & Pancreatic Diseases International2019，18，5： | 3 |
| 19 | Improved guided bone regeneration by combined application of unmodified, fresh autologous adipose derived regenerative cells and plasma rich in growth factors:A first-in-human case report and literature review显示文摘BACKGROUND Novel strategies are needed for improving guided bone regeneration(GBR) in oral surgery prior to implant placement, particularly in maxillary sinus augmentation(GBR-MSA) and in lateral alveolar ridge augmentation(LRA). This study tested the hypothesis that the combination of freshly isolated, unmodified autologous adipose-derived regenerative cells(UA-ADRCs), fraction 2 of plasma rich in growth factors(PRGF-2) and an osteoinductive scaffold(OIS)(UAADRC/PRGF-2/OIS) is superior to the combination of PRGF-2 and the same OIS alone(PRGF-2/OIS) in GBR-MSA/LRA.CASE SUMMARY A 79-year-old patient was treated with a bilateral external sinus lift procedure as well as a bilateral lateral alveolar ridge augmentation. GBR-MSA/LRA was performed with UA-ADRC/PRGF-2/OIS on the right side, and with PRGF-2/OIS on the left side. Biopsies were collected at 6 wk and 34 wk after GBRMSA/LRA. At the latter time point implants were placed. Radiographs(32 mo follow-up time) demonstrated excellent bone healing. No radiological or histological signs of inflammation were observed. Detailed histologic,histomorphometric, and immunohistochemical analysis of the biopsies evidenced that UA-ADRC/PRGF-2/OIS resulted in better and faster bone regeneration than PRGF-2/OIS.CONCLUSION GBR-MSA with UA-ADRCs, PRGF-2, and an OIS shows effectiveness without adverse effects. | ?nder Solakoglu Werner G?tz Maren C Kiessling Christopher Alt Christoph Schmitz Eckhard U Alt | 2019 | World Journal of Stem Cells2019，11，2： | 3 |
| 20 | Endoscopic ultrasound-guided celiac plexus neurolysis using a reverse phase polymer显示文摘AIM:To assess the feasibility of endoscopic ultrasound(EUS)guided celiac plexus neurolysis(CPN) using a poloxamer. METHODS:In this prospective evaluation,six Yorkshire pigs underwent EUS-guided CPN.Three received an injection of 10 mL of 0.25%Lidocaine plus methylene blue(group 1) and three received an injection of 10 mL of 0.25%Lidocaine plus blue colored poloxamer(PS137-25)(group 2) .Necropsy was performed immediately after the animals were sacrificed.The abdominal and pelvic cavities were examined for the presence of methylene blue and the blue colored poloxamer.RESULTS:EUS-guided CPN was successfully performed in all 6 pigs without immediate complication.Methylene blue was identified throughout the peritoneal and retroperitoneal cavity in group 1.The blue colored poloxamer was found in the retroperitoneal cavity immediately adjacent to the aorta,in the exact location of the celiac plexus in group 2.CONCLUSION:EUS-guided CPN using a reverse phase polymer in a non-survival porcine model was technically feasible.The presence of a poloxamer gel at the site of the celiac plexus at necropsy indicates a precise delivery of the neurolytic agent. | Keith L Obstein Fernanda P Martins Gloria Fernández-Esparrach Christopher C Thompson | 2010 | World Journal of Gastroenterology2010，16，6： | 3 |
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